Financing Healthcare in the United States

“The Patient Protection and Affordable Care Act (PPACA), also known as Obamacare, was proposed by health associations” in order to increase access to healthcare services, improve the quality of those services, and decrease the cost of both services and prescription drugs. The legislation mandates that all Americans have health insurance and provides subsidies to those who cannot afford it.

“The legislation also requires insurance companies to cover pre-existing conditions and limits their ability to charge higher premiums.” Finally, the legislation establishes health insurance exchanges, where people can purchase private insurance plans. The first goal was to increase access to healthcare. This was to be accomplished by mandating that all Americans have health insurance and by providing subsidies to those who could not afford it. The mandate went into effect in 2014, and the offerings are available to those with incomes below “400% of the federal poverty level.”

“The subsidies are available in the form of tax credits,” which can be used to purchase insurance on the health insurance exchanges. The second goal was to improve the quality of healthcare. “This was to be accomplished by requiring insurance companies to cover pre-existing conditions and by limiting” their ability to charge higher premiums.

The pre-existing condition requirement went into effect in 2014, and the premium limits went into effect in 2017. The third goal was to decrease the cost of healthcare services and prescription drugs. This was to be accomplished by establishing health insurance exchanges, where people could purchase private insurance plans. The deals are intended to create competition among insurance companies, which would theoretically lead to lower prices.

In addition, the legislation included a number of provisions intended to decrease the cost of prescription drugs, such as requiring drug companies to give rebates to Medicare and Medicaid and allowing the importation of prescription drugs from Canada. So far, the effect of the PPACA has been mixed. On the one hand, it has helped millions of Americans gain access to healthcare services that they would not have had otherwise.

On the other hand, it has caused premiums and deductibles to rise, and some people have found that their favorite doctors and hospitals are not covered by their new insurance plans. In addition, the cost of prescription drugs has not decreased as much as was hoped. The increase in access to healthcare has been the most positive aspect of the PPACA. Prior to the implementation of the law, an estimated 48 million Americans were without health insurance.

As of 2016, that number had fallen to 28 million. The subsidies have made insurance more affordable for those who need it, and the mandate has helped to ensure that people do not wait until they get sick to purchase insurance. The increase in premiums and deductibles has been the most damaging aspect of the PPACA.

“Prior to the law, the average premium for a family of four was $12,000,” with a $1,000 deductible. As of 2016, the average premium had risen to $18,000, and the average deductible had risen to $3,000. This increase has made it difficult for many people to afford insurance and has led to some people dropping their coverage.

The final goal of the PPACA was to decrease the cost of healthcare services and prescription drugs. This has not been accomplished to the extent that was hoped. The health insurance exchanges have not been as effective as was expected in creating competition among insurance companies, and the cost of healthcare services has continued to rise. In addition, the price of prescription drugs has not decreased as much as was hoped due in part to the fact that drug companies have been able to find ways to avoid the rebates required by the law.

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Financing Healthcare in the United States

The financing of healthcare in the United State is complex, involving interest groups, federal and state governments, consumers, health associations, health insurance companies, and pharmaceutical companies. Health associations continually make demands for legislative and policy changes in the processes for financing health services.

Talk about a legislative change that was proposed by health associations and its effect on access to service, quality, cost of services, and cost of drugs. Briefly explain the legislation.